Monday, September 18, 2017

**Surgery Not Covered By Insurance**

** possibly somewhat misleading as insurance may cover PART of the costs for removal of an anal cyst on September 1, 2017**

I had surgery to remove an anal cyst on 9/1/2017. The surgery was uneventful and healing was quick.
However, because it took two months to get a referral (from my doctors office) for this surgery, my health insurance through Regence Blue Cross/ Blue Shield lapsed.
My new insurance through my new job (which I started on July 2) was effective on 9/1/2017 BUT....and this is a big BUT...there is a $1000.00 deductible which I had no way of reaching considering the insurance kicked in the exact same day I had the surgery.

I have given my new insurance information to all three providers (anesthesia, surgeon, and hospital)

I got the bill today for the anesthesia. $963.00, and it doesn't say whether that is before or after submitting to my insurance company.

The cost from the surgeons' office is $700.00

I haven't received the hospital bill yet (and truthfully it's the least of my worries as St Charles Medical System is very good with working with financial problems--ie when I was admitted in 2006 with pulmonary emboli my entire hospital bill was waived).

There are two issues right now.

1) Will my insurance cover any of this? There was no pre-authorization from Providence (my new insurance provider) because at the time the surgery was scheduled I was still covered by Regence Blue Cross/Blue Shield

2) Again, if my Providence plan does cover the surgery and related costs, there is a $1000.00 deductible which I had no hope of reaching since the surgery was on the same day that my Providence insurance became effective.

There are probably co-pays as well.

In short that means that I will have to pay at least $1000.00 out of pocket for a surgery that would have been partially covered (IF NOT FULLY COVERED) by my Blue Cross/Blue Shield insurance up until 8/31/17.

TIMING IS EVERYTHING, and hindsight is always 20/20.

The reason that I am trying to raise $5000.00 instead of just the $1000.00 that I know for sure will be my responsibility is 1) the co-pays that may be required and 2) as stated above, my current insurance may not cover ANY of the costs incurred due to the surgery not being pre-authorized.